A Delhi stung

The municipal corporations have failed to keep drains unclogged, leaving Delhi buzzing with mosquitoes like never before. DNA takes a look at how authorities are unprepared to fight the fast approaching seasonal menace of dengue and chikungunya despite repeated raps from the HC.

Manas Malhotra, 26, has been lying on his bed after he had his right leg fractured recently. Many of his friends did not initially believe the reason he gave for the road accident he was involved in. “I was returning home on my motorbike. I hadn’t pulled down the helmet visor because it was hot and humid. A handful of mosquitoes suddenly buzzed into my eyes, and I lost balance,” he says.

This summer, many are saying Delhi has never been bugged like this before. The tiny blood-sucking insects are no longer a mere annoyance. Swarms hovering with a lingering, bothersome whine can be seen even at corporate offices and plush department stores that use best of repellants. Bite, swat, itch and welt are the new buzz words!     

Residents complain the three main municipal corporations in north, east and south Delhi have failed to keep drains unclogged that has triggered this sudden surge in the mosquito population. Experts say these are mostly not Aedes aegypti that breed in fresh standing water and transmit dengue and chikungunya. These are Culex that breed in dirty, stagnant water, and have become a nuisance.  

As it is, Delhi has reported 12 cases of dengue and three of malaria this year, according to the South Delhi Municipal Corporation (SDMC) that compiles citywide data for these diseases. This indicates an early spread of the vector-borne diseases. Civic bodies often under-report dengue numbers in Delhi to escape action. This derails plans to fight the notifiable illness that becomes a menace every year between April and October.

“We never had it so bad. Mosquitoes have taken over the city. We are keeping all windows closed. It is almost impossible to stand outside after 7 pm,” says Rakesh Singh, a resident of south Delhi’s Lajpat Nagar.

The three civic bodies claim they have inspected 58 lakh houses this year. Fumigation has taken place at 74,000. Inspectors have found 3,318 homes violating norms put in place to check mosquito breeding. But for violations, only 305 cases have been filed — 277 in south, 22 in north and six in east Delhi.

Residents say these are mere numbers, and ground realities are different. “Domestic Breeding Checkers (DBCs) visit houses only to mechanically mark them. They are not bothered if anyone has a mosquito-breeding water cooler. They don’t care even when they see an open drain,” says BS Vohra, president, East Delhi RWA Joint Front Federation.

Here’s what explains the situation — to a large extent. The health departments of the civic bodies have been crippled by manpower shortages. North Delhi has only 152 medical officers and malaria inspectors. As many as 376, or 71 per cent, of the 528 sanctioned posts have remained vacant for the past two years. East Delhi has only 72 of these officials. As many as 155, or 68 per cent, of the 227 posts have remained unfilled during this period.

Officials, however, say the major onus to control mosquito breeding lies with the public. “In every case of dengue, the affected person has been found bitten within 200 meters of his or her surroundings,” says Pramod Verma, Deputy Health Officer (DHO) of North Delhi Municipal Corporation. In most colonies, which do not have piped or regular water supplies, residents store water in mostly poorly covered containers, resulting in mosquito breeding, he says.  

“Fresh water puddles can be seen on roads, terraces, balconies and in back lanes. Residents must ensure this doesn’t happen. They must change the water in containers every week to break the cycle of the dengue larva breeding,” Verma says. While the male mosquito feeds solely on plant nectar during its brief existence, the female requires a blood meal to nourish eggs.  

The civic body for south Delhi that is better off in terms of funding and human resource has also been reporting a high number of cases from its congested colonies such as Shaheen Bagh, Jamia Nagar, Govindpuri, Abul Fazal Enclave, Sangam Vihar and Okhla. It’s relying mainly on awareness. “We started work on awareness in April. Usually, it begins in June. This year, we have also introduced a ‘dengue homework card’ programme in the corporation and private schools. This will cover around six lakh students in our jurisdiction and help increase awareness,” says Medical Health Officer (MHO) BK Hazarika.  

Students between classes IV and XII will be told what needs to be done at home to check breeding. “World over, such as in cities like Singapore, people do not allow water to collect in their surroundings. They have almost overcome dengue. DBCs who check 50 households a day are not able to cover the entire ground. Each house must resolve against water collection — even in a bottle cap,” says Hazarika.

The three corporations together have around 3,500 DBCs. However, the task for these daily wagers is difficult because Delhi has some vast colonies and unauthorised settlements. People often do not allow them to enter their houses or terraces to check overhead tanks, vases, pots and coolers. Last month, an organisation of DBCs struck work and demanded their jobs be regularised.  

“We have been working for the corporations for the last 10-15 years. But we are not their permanent employees. We also want service benefits. However, they say these posts are not official and they don’t have funds for us,” says Santosh Singh, a DBC and member of an Anti-Malaria Workers’ Union. Officials say these are workers hired on contract for door-to-door surveys. “And because most of them are unskilled, they cannot be employed even as field workers,” says an official.  

Dengue causes flu-like illness. Symptoms include headache, pain in other body parts, nausea, vomiting, swollen glands and rashes. Death, though rare, is from complications such as haemorrhagic fever and shock syndrome. At least 10 people died of dengue in Delhi last year, according to SDMC’s data. Five victims had come here from outside. Overall, the disease affected 9,271 people in the city in 2017. A total of 4,726 patients were from Delhi, while 4,545 had come from other states for treatment.  

The tropical illness had claimed its first victim in the city last year on August 1, when a 12-year-old boy died of shock syndromes at Sir Ganga Ram Hospital (SGRH). Three more deaths were reported in October by SDMC. In 2016, at least 21 dengue deaths were reported from various city hospitals. Nine took place at AIIMS. Though the official citywide figure was 10.

The numbers of malaria and chikungunya cases recorded in 2017 stood at 1,142 and 940, respectively. The most common symptoms of chikungunya are fever and joint pain, and patients may report headache, muscle pain, joint swelling or rashes.

Experts caution that mosquito-borne disease cases may rise even before the monsoon this year. “The trend seems to be different. Humidity levels will be higher this time, which will have an impact,” says Dr SP Byotra of SGRH.  

On April 11, the Delhi High Court expressed anguish over the lack of cleanliness and hygiene, and said the city will die if the situation does not improve. The court said people may have to move out to make room for the increasing garbage, and warned authorities of stringent action if anyone dies or gets infected with dengue and chikungunya. The court said if immediate action is not taken by the Centre, the Delhi government or the civic bodies, it will be forced to take strict action against all of them.  

The court said that there appear to be “no sensitivity” towards health and entitlement of citizens to a clean environment. “No human or animal should be co-existing with garbage. This is 21st Century India, you can’t make people of Delhi live like this.”We see no reason as to why in the event of any death caused by vector-borne diseases, persons responsible be not charge with culpable homicide,” it said.

Lieutenant Governor Anil Baijal directed all civic agencies on April 14 to prevent dengue, chikungunya and malaria. He also directed the health department and other agencies to be prepared in terms of logistics for dengue patients.  

The corporations plan to issue an advisory to schools next week. “They must have students cover themselves properly, and stop mosquito breeding in areas up to 200 metres of their premises. Our inspectors are already visiting schools,” says Hazarika. But given the way the Centre, the Delhi government and the civic bodies are struggling to get a handle on the problem, there does not seem to be much hope this year either.

THE STING

The city will die if the situation does not improve. No human or animal should be co-existing with garbage. This is 21st Century India, you can’t make people of Delhi live like this. We see no reason as to why in the event of any death caused by vector-borne diseases, persons responsible be not charge with culpable homicide
— Delhi High Court (April 11)